Individual provider Active NPI

Jennifer Mara Jacob, MD

  • Pediatrics Physician
  • Seattle, WA
National Provider Identifier
1851416028
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD60147265 Issued in WA
Practice address
904 7TH Ave
Seattle, WA 98104-1132
Phone
(206) 292-2249
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A95584 CA
Pediatrics Physician 208000000X MD60147265 WA Primary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X MD60147265 WA

Addresses

Primary practice location

904 7TH Ave
Seattle, WA 98104-1132

Mailing address

7600 Evergreen Way
Everett, WA 98203-6421
Phone (206) 860-5414

Other practice location 1

3901 Hoyt Ave
Everett, WA 98201-4988
Phone (425) 339-5450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101021000539 WA Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 2365635455 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A95584CAMDPediatrics Physician
MD60147265WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Current Accepting new patients
The Polyclinic PLLC CurrentSince Dec 10, 2023 Accepting new patients
Optum Care Washington PLLC Pediatrics CurrentSince Dec 4, 2023 Accepting new patients
Swedish Health Services CurrentSince Oct 1, 2015 Accepting new patients
The Polyclinic PLLC Pediatrics Current Accepting new patients
Multicare Health System CurrentSince Aug 30, 2010 Accepting new patients
Swedish Health Services Pediatrics CurrentSince Oct 1, 2015 Accepting new patients
The Polyclinic CurrentSince Dec 10, 2023 Accepting new patients
Multicare Health System CurrentSince Aug 30, 2010 Accepting new patients
Optum Care Washington PLLC Pediatrics CurrentSince Dec 4, 2023 Accepting new patients
The Polyclinic PLLC Past Accepting new patients

Locations

3901 Hoyt Ave
Everett, WA 98201
Phone (425) 258-3903

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

200 Lilly Rd NE
Ste C
Olympia, WA 98506
Phone (360) 918-8336

1145 Broadway
Seattle, WA 98122

904 7th Ave
Seattle, WA 98104
Phone (206) 223-6487

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

317 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 403-1400

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3889/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jjacob81434@direct.tecmc.com

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1851416028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036421",
            "telephone_number": "206-860-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 7TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041132",
            "telephone_number": "206-292-2249"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Hoyt Ave",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982014988",
            "country_code": "US",
            "telephone_number": "425-339-5450",
            "fax_number": "425-259-1151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOB",
        "first_name": "JENNIFER",
        "middle_name": "MARA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A95584",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60147265",
            "primary": true
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "WA",
            "license": "MD60147265",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.